Truss



TRUSS Filed June 19, 1953 v iii!!! 1 Patented May 18, 1937 UNITED STATES PATENT OFFICE 1 Claim.

My invention relates to metal or semi-rigid trusses, used in the treatment of hernia.

Heretofore it has been necessary to have a specialist fit a truss to the body of the patient in each individual case. The fitting was usually accomplished by bending and distorting the exceedingly stiff spring metal frame of the truss to vary the position of the pad and the direction and amount of pressure exerted thereby.

m It has been impossible for a person to fit a truss to himself with only a rudimentary knowledge and without the aid of an expert. Consequently persons in isolated districts have often been unable to obtain proper treatment. My invention is designed to permit a patient to fit the truss to himself with facility and without the assistance of an expert, and even when thus fitted it will perform its intended function better than any conventional strap or spring truss fitted by 20 an expert. Further this truss may be more easily and accurately fitted by an expert than the spring type of truss, which heretofore was the best available.

Trusses of various types have long been used 25 in the treatment of hernia, but as far as I am aware, none of them have been entirely satisfactory, either in their utility for the intended purpose or for the comfort of the wearer. As far as the functioning of trusses is concerned,

30 three principal errors have often been madefirst, the point of application of pressure has been incorrect, second, the direction and amount of the pressure applied has been improper, and third, pressure has been caused on the pubic bone 35 and elsewhere which is not only uncomfortable,

but possibly injurious.

The discomfort to the wearer of previous types of truss has principally been due to the fact that parts of the truss have extended tightly 40 over the hip bone, causing irritation and perhaps inflammation of the skin, and parts of the truss have pressed against the pubic bone.

It is an object of my invention to provide a. truss which, when applied to the proper part of 5 the wearers body, will be pressed thereagainst in the correct manner to hold the parts securely in their normal position without undue pressure so that they may have an opportunity-to heal, or at least prevent further displacement of the '50 parts in severe cases.

It is further an object of my invention to provide a truss which will not press upon any bones of the wearer which are close to the surface, so that no discomfort or soreness will be It is also an object to provide a truss of very light weight and clean design, so that it is not burdensome nor appreciably noticeable because of its bulk.

A further object is to provide means whereby 5 the harness may first be applied and fitted easily to the wearers body in a comfortable manner, and in proper relationship to the hernia and to the bones, next a pad may be placed properly over the hernia in a comfortable manner wherever it may protrude from the bowels, and finally the pad may be attached to the harness in the precise position suitable for each individual case, and wherever the pad may be disposed relatively to the harness, giving particular attention to the amount, type and direction of pressure applied to the part undergoing treatment.

' Other objects of my invention will be set forth in the following description, and particularly will be evident in the preferred form of my invention shown in the drawing.

My invention comprises the novel parts and their arrangement in combination as shown in the accompanying drawing and described in this specification, and as particularly defined in the claim appended to the same.

Figure 1 is a perspective view of my invention;

Figure 2 is a sectional view through a pressure pad and the front portion of my device.

Figure 3 is a detail view of a back pad, as seen from the rear of the wearer.

Figure 4 is a sectional view along the line 4-4 of Figure 3.

.Figure 5 is a perspective of a regulating washer which may be placed behind the pressure pad.

Figure 6 is a section on line 6-6 of Figure 3.

The build of individuals in the abdominal region diifers greatly. They may be thin, stout, or obese. The location of the hip bones relatively to the public bone varies in different individuals. One hip is sometimes higher than the other. The hernia is generally located in the region immediately above the pubic bone, and well below the points of the hip bones. ,Any truss supported by flexible straps must employ straps which pass over the hip bones, and which press thereon, to the great discomfort of the wearer, or the strap must be loose above the hip bones, and reliance placed on perineal or leg straps to hold the hip straps down. The latter being the principal source of pressure, theyinduce pressure upwardly at the hernia and downwardly upon the hip bone, instead of the requisite downwardly dimay be dangerous in itself; it may produce a focal point for a cyst or the like.

It is of the utmost importance, therefore, not' merely to the proper functioning of the pressure pad, but also to the good health and comfort of the wearer, that the truss fit snugly but comfortably above the hip bones, and above the pubic bone, without appreciable pressure on either, but producing a gentle, holding pressure inwardly and downwardly directed at the internal ring which is the proper point with relation to the hernia. It is of importance, then, that the truss accomplish all these ends, yet be adaptable to the needs of individuals of widely varying builds and even having minor individual malformations.

The preferred form of my device has bodyembracing, somewhat resilient, manually deformable bands I, which are curved, can be shaped readily with the hands to fit the body, and when thus fitted will maintain such conformation, after removal and replacement, and which are also arched to pass well up on the hip bones so that uncomfortable pressure will not be exerted against flesh directly over a bone. These bands may be covered with leather if desired. The front ends of these bands are connected to a front plate 2 by pins or bolts II). A plurality of holes is provided at each end of the plate 2 to receive these bolts, so that the body-embracing portion of the side bands may be raised or lowered with respect to the plate according to the build of the wearer and the part to which pressure is to be applied.

On the other ends of the side bands I, back pads or plates 3 are mounted, which pads preferably are flat surfaced, to distribute their pressure, and extend considerably below the bands. A strap 4 may be connected between the back pads 3, holes 40 in the strap being engaged with lugs 30, 3| or 32, as desired. The back pad 3 may also be moved angularly relatively to the body band I by moving the screw 3| to holes 33 or 34, the pad swinging about the pivot screw I I, or it may be moved lengthwise of the band I by merely loosening screws II and 3| and sliding them in the slots I2 and I3, respectively. The two spaced screws insure that the desired angular relation of the band and back pad will be maintained.

In the plate 2 are out two series of substantially parallel arcuate slots 20 and 2I extending transversely of the wearers body, one' of such series being at each end of the plate. All the slots in each of the series correspond substantially to arcs of concentric circles. Through these slots a: bolt 22 may be inserted which may be screwed into a pad 5. One or more tapered regulating washers 6, inserted between the plate 2 and the pad 5, may be turned to change the angularity of the pad relatively to the plate.

Across the upper edge of the plate 2 a. pliable guard 1 may be provided, secured to the plate 2 by rivets or the like. This guard or shield may consist of an outer leather piece I0 and two leather pieces II and I2 on the inner side of the plate 2.

The application of my device to the body of the wearer may be made in the following manner. First, the proper size of plate 2 is selected. Such selection may be made by reference to the distance between points on Pouparts ligaments, or the groin lines, located half way between the ilium or point of the hip bone and the pubic bone. Next, the proper size of bands I are selected and placed around the sides of the body, and the plate 2 is then raised or lowered to position it above the pubic bone in the proper position, and the bands I are connected to the plate by the screws ID, to hold the plate and bands in the positions which they thus assume. The bands and plate are then shaped to fit the body conformation. The back pads 3 are next adjusted angularly and lengthwise of the band I, by means of the slot and bolt arrangement, to position them as desired at the back of the wearer. One or more cross straps 4 may then be utilized, either crossed or in a horizontal manner, between the pads 3. The strap or straps may be connected between the lugs 36, 3| or 32 on the opposite pads, or any combination thereof, in the manner which will best secure the truss to the body of the wearer for the particular case. The holes 40 will allow adjustment of the strap to be made according to the size of the wearer.

Only when the truss frame has thus been satisfactorily shaped and adjusted to the body of the wearer, the pad 5 will be put in place over the hernia in the proper position and manner. When thus positioned, a screw 22 will be inserted through the appropriate slot which will be found adjacent to the pad, and the pad may thereby be held to the truss frame in the exact position desired. According to the particular case, one or two of such pads may be used. The pad is preferably of non-circular shape, and may be somewhat elliptical, as illustrated, so that by turning the pad either concentrated or a distributed pressure can be applied as required in the instant case. However, pads of various shapes are available for use, the proper shape being selected for each individual case.

The direction of pressure may also be varied according to the particular case by turning the tapered Washer 6 to the desired position, or by substituting a washer of greater or less taper, as required. The intensity of pressure can be increased or decreased by varying the thickness of the washer 6, as the particular case may require. After these various adjustments have been made the truss will be properly adjusted for application to the wearer, and since it is made of somewhat resilient material it can be removed and replaced without fear of its getting out of adjustment.

The direction of pressure of the pad 5 against the injured part will be correct, namely, somewhat downwardly at right angles to the inguinal canal, for the elongated back pads or plates 3 extend considerably below the body bands, and the lower ends thereof are connected to the upper portion by a neck of manually deformable material and consequently may readily be bent inwardly toward the body the proper amount so that the points of resistance are well below those of the old type of truss. The line of pressure joining the lower part of a back plate 3 with the pressure point of a pad 5 will be substan- 75 tially normal to the inguinal canal. In order to distribute the resistance pressure of the back plates over a considerable area of the wearers body and at the same time insure that the truss will be held securely in place, I prefer that their lower ends be broadened in the form of a lobe joined to the upper part by a relatively narrow, ductile neck portion.

It will be seen that the wearers comfort is assured with my truss, and that the pressure exerted at the point of injury will be such as to seal the opening by a downward and backward pressure normal to the canal, instead of separating the muscles and dilating the inguinal canal by an upwardly directed pressure as often results from conventional types of trusses. Since the construction of my device is preferably principally of aluminum and leather, it is very light, and the parts have been formed to conform to the body of the wearer, so that no unsightly projections will be noticed when it is being worn.' Pure aluminum and its light-weight aluminum-base alloys including a very small percentage of other metals, are characterized by their readily deformable quality combined with some resilience, sufiicient to return a member made of such material to its original shape after being bent only slightly. They are not elastic as are heat-treated bronze and spring steel, and consequently my side bands made of such materials are manually deformable, that is, they may be readily shaped to the configuration of the wearer with the hands alone, and without requiring to be bent in a vise. When once fitted the frame will, however, being constructed of somewhat resilient material, retain its pecularities of shape after removal and replacement, to fit the body accurately.

The shield 1 may be employed to prevent any obesity of the wearer bearing on and depressing the plate 2 from its proper position, and it eliminates any discomfort which might be caused by the sharp upper edge of the front plate 2 cutting into the overhanging flesh. Furthermore, owing to the width and yielding construction of this shield, such an obesity will not displace the front plate 2 when the wearer stoops over.

What I claim as my invention is:

A hernia truss comprising, in combination, two metal body bands, a single, continuous front plate, means adjustable to raise or lower the body-engaging portion of said bands with respect to the front plate, to secure the front ends of said bands one to each side of said front plate in thedesired adjusted position, two elongated back plates, one supported from each body band to react against the wearers body one at each side of the spine well below said bands, means, adjustable to vary both the angular and translational relation of said bands and said back plates, to fix the back plates in the desired relationship to said bands, a pressure pad, and means 

